These are some example of thoughts that resound in the minds of children, teens, and adults who grapple with social anxiety. In school, children with social anxiety often stand at the edges of the crowd, watching and listening, but rarely saying anything. They wish they could just be like everyone else, but they believe that they don’t measure up in some way. Once they’ve graduated school, the socially anxious young adult may make life choices that will allow him or her to have minimal contact with people. Careers are chosen that involve sitting in a cubicle, invitations to parties and get-togethers are turned down, while in day to day life adults with social anxiety disorder rush in and out of public areas in order to avoid casual conversation. Social anxiety traps its sufferers in a prison constructed of their own minds.

The Psychology of Social Anxiety

There is a stage of adolescence that many of us are familiar with- that time in life where we are self conscious about everything. We worry that we are wearing the wrong outfit, that we may say something ‘uncool’ or that people will find out our families are not as normal as they look. An early psychologist called this the perceiving of an ‘invisible audience’ at all times. Some people move through that stage, and realize that their peers are more likely to be worrying about their own appearances than to be judging anyone else. But for some, the invisible audience sticks, taking up a stand of bleachers in their minds, constantly analyzing and criticizing. Self-evaluative and self-critical thoughts frequently place those with social anxiety into extreme discomfort when they need to be around others. “You have such a huge blotch on your face; there is no way you could go out today”. “You know you’re going to get red and stutter when you talk to your boss, just stay at your desk and look down.”

A routine situation like standing on line at the cafeteria is experienced as if the person is the center of people’s attention. Others are watching. And judging. And deciding that we are not good enough. Some sufferers liken their life to reporters viewing their every move and waiting to photograph them at the one moment when they look disheveled. In social anxiety disorder, we view ourselves as a social object.

This can be exhausting. Imagine all your worst critics crammed into one space, telling you all those terrible things about yourself that you hope are not true. Imagine dealing with these thoughts every minute of every day. Anxious thoughts about the negative judgments of others have a direct effect on our central nervous system. Physiological anxiety symptoms of worry-muscle tension, headaches, and nausea, give way to outright panic attacks when encountering unfamiliar people or in situations of possible scrutiny by others. People who struggle with social anxiety may be able to get to work or school, and perform well. However, they will often do everything they can to avoid taking risks. They will sooner stay at the same job for 20 years than risk facing their boss and asking for a promotion. They will accept a lower grade on a test, even if it was due to the teacher’s error, because talking to the teacher would require climbing an Everest of fear.

How does Social Anxiety Develop?

Although people vary on the introvert-extrovert continuum, some people are naturally more inhibited and fearful, their central nervous systems more reactive to stressors. This alone will not produce Social Anxiety Disorder or any other anxiety disorder. Research has highlighted a combination of factors that contribute to social anxiety.

Negative Beliefs about the Self: We each have certain beliefs about ourselves. These beliefs lead us to interpret situation that occur in different ways, and can trigger certain reactions. For instance, if Dana’s belief is “I am a strong person”, she may feel confident. Then, when she faces a challenge such as a road test, she may remember all the things she learned in driver’s ed, and pass her test. Say Dana believed “I can’t do anything right”, she may feel insecure. Then, when facing the same road test, she may find her hands shaking and her brain freezing as she tries to execute a parallel park over and over again. Same driver’s ed course, same person, same road test- but each belief led to a different outcome.

Perfectionism: Research shows that perfectionism is associated with being critical of one’s self. Some people naturally have perfectionistic tendencies. They tend to push themselves to perform perfectly. Then, if they think they won’t say something perfect, they choose not to say anything at all. People with perfectionistic tendencies would often rather give up then try and fail.

Negative Experiences: When people have received negative responses to their attempts at socializing, they may be more likely to analyze each thing they think of saying so they can avoid a repeat of those bad experiences. For example, if Chaya excitedly tells her 4th grade friends that her favorite food is sushi, and everyone makes fun of her, she might think twice, or seven times, before sharing any personal details again. She may not know why they laughed at her, but she can decide to make sure there is no chance of it happening again- by staying quiet next time.

Parental Modeling: Children often learn behaviors and unhelpful beliefs from watching those around them. When parents, who can be important role models in a child’s life, do things like avoid social functions or express fear before making a phone call, children may learn that interacting with others is scary and should be avoided.

There are many possible causes for social anxiety. It can happen to anyone, and most of the time, there is no one person or event responsible for causing social fears. However, parents, friends, and teachers can be influential in recognizing when someone is suffering and encouraging them to get help.

There are many available treatments for social anxiety. Cognitive Behavioral Therapy (CBT) is one treatment that has been proven to work over and over again in a range of studies. During CBT sessions, people can learn to recognize what goes on in their minds and bodies when they are faced with uncomfortable social situations. They can learn to identify exactly which beliefs are holding them back. Then, they can change those beliefs and learn to trust their own abilities. If you or someone you know suffers from social anxiety, remember that while this is a very real and painful disorder, there is no need to deal with it alone.

Bio:

5TWC uses the latest scientific and evidence-based cognitive and behavioral treatments to alleviate emotional problems. Our experienced clinicians offer intensive and customized treatment plans that enable our clients to maintain a high level of personal control throughout the treatment process. Jonathan Cohen, PsyD is the director of 5TWC and has advanced training in evidenced-based therapies for emotional and behavioral problems. Sara Schwartz-Gluck, LCSW is a Clinical Social Worker who works with children and adults, and has lectured at schools and mental health organizations throughout NY and NJ.